Title : Lysozyme – enzybiotic as promising weapon against antimicrobial resistance
Abstract:
Antibiotic resistance is a global problem. The incidence and prevalence of antimicrobial-resistant-bacterial infections has attained incongruous levels during 21st century and threatens global public health as a silent pandemic, necessitating urgent interventions. Enzybiotics are microorganism-degrading enzymes found in various natural sources. Although discovered a century ago, they were in the shade of antibiotics. The term enzybiotic implies those enzymes acting on the bacterial cell′s wall degradation, the way in which lysozyme acts. Lysozyme is among the most studied enzybiotics. Lysozyme meets the enzybiotic′s criteria as it has primary antibacterial and antifungal effects, but also has additional effects: antiviral, anti-inflammatory, immunomodulatory and pro-regenerative. Enzymatic muramidase activity of lysozyme is responsible for killing primarily gram-positive bacteria. Lysozyme can also kill bacteria independently of peptidoglycan hydrolysis through a mechanism involving its cationic nature. The presence of two complementary bactericidal mechanisms (enzymatic and non-enzymatic) reduces the probability of complete escape of pathogenic bacteria from the antibacterial action of lysozyme. In the case of modification of the structure of peptidoglycan which increases the microorganism's resistance to the enzymatic action of lysozyme and even in the case of complete loss of the cell wall (L-shape), bacteria a priori remains more or less sensitive to the cationic mechanism of this protein. The impact of prescribing antibiotics in the context of primary health care, especially broad-spectrum antibiotics and empiric prescribing, often without justified indications, is significant. Family doctors have a special role in bridging the problem of bacterial resistance, because 90% of antibiotics are prescribed for outpatient treatment. Approximately 70% of all antibiotics prescribed by these doctors used to treat acute upper respiratory infections (URI), which includes the acute pharyngitis. In 79% of cases, the use of antibiotics in URI was unnecessary. Natural basis of lysozyme, along specifics of action and unique pharmacological effects in the absence of bacterial resistance, provides the ability to overcome the risk of antibiotic resistance using preparations based on lysozyme in the empirical treatment of viral and uncomplicated bacterial infections of the oropharynx.
